SURG 250 - Surgical Technology Clinical 1

1. Demonstrate use of appropriate PPE (Personal Protective Equipment).

a. Demonstrate when different types of PPE are required and in which procedures or areas.

i. Hair coverings

ii. Scrub attire

iii. Shoe covers

iv. Warm up jackets

v. Masks: procedural, surgical, laser, N95

vi. Eye protection vii. Gowns: surgical, hazard, reinforced

viii. Gloves

2. Demonstrate knowledge of standard operating room equipment and supplies necessary for each department and surgical procedure.

3. Demonstrate knowledge and application of each role of the surgical technologist during each phase of perioperative case management.

4. Perform all applicable duties for the first scrub role.

a. Perform preoperative duties.

i. Demonstrate efficiency of movement while establishing a sterile field.

ii. Demonstrate the creation of the sterile field by opening sterile supplies.

1. Back table

2. Basin

3. Instruments

4. Supplies

iii. Perform duties to reflect timeliness and anticipation of team members.

iv. Perform all required tasks for entry into the sterile field.

1. Hand hygiene and scrub

2. Don surgical gown

3. Demonstrate hand drying

4. Demonstrate closed glove technique

5. Gown and glove another

v. Organize the back table, supplies and equipment for each surgical procedure.

1. Drape a mayo stand.

2. Organize supplies and instruments in an efficient timeframe.

3. Perform a surgical count in the correct order.

4. Receive and label medications onto the field.

5. Load blade(s) and suture for either a right or left-handed surgeon.

vi. Perform surgical draping of a patient.

vii. Demonstrate the tasks necessary to start a surgical procedure.

1. Secure and hand off cords and tubing.

2. Establish a neutral zone.

3. Prepare sponges for a case start.

4. Participate with the surgical pause, ‘Timeout.’

b. Maintain intraoperative duties.

i. Organize supplies and instruments during each phase of the procedure.

ii. Pass all requested items to the surgical team.

iii. Anticipate the needs of the surgeon while preparing supplies according to the steps of the procedure.

iv. Recognize patterns for supply and instrument requests.

v. Demonstrate example of point of use cleaning.

vi. Request any additional necessary items from the circulator.

vii. Monitor the field for breaks in sterile technique.

viii. Correct any breaks in sterile technique.

ix. Establish a clean/dirty scenario.

x. Monitor all solution and medication amounts used in the field.

xi. Keep track of blood/fluid loss and report.

xii. Track all supplies that enter cavities and sponges on the field.

xiii. Complete closing counts.

xiv. Prepare/apply sterile dressings for the patient.

c. Complete postoperative duties.

i. Secure sharps from the field for identified disposal.

ii. Allocate different waste and recycle items.

iii. Prepare all instrumentation for delivery to decontamination.

iv. Assist with patient movement to a stretcher.

5. Demonstrate all applicable duties for the second scrub role.

a. Catheterize the patient for urinary output.

b. Prep the patient with a surgeon requested solution.

c. Apply all necessary monitoring and safety devices.

d. Prepare to retract tissue.

e. Cut the suture.

f. Hold additional instrumentation (clamps, scopes, retractors).

g. Assist with hemostasis.

6. Demonstrate all applicable duties for the circulating role.

a. Assist with equipment preparation.

b. Position the patient.

c. Gather additional supplies.

d. Assist with documentation.

7. Demonstrate cautious movement around and within the sterile field.

a. Use awareness with all movements.

b. Exercise lateral hand/arm motions.

c. Avoid contamination.

d. Correct any breaks in sterile technique.

i. Self

ii. Team

8. Demonstrate knowledge of hemostasis by preparing hemostatic options on the field.

a. Examine each type of hemostatic option and surgeon preference.

i. Mechanical

ii. Chemical

iii. Thermal

9. Demonstrate suture knowledge by choosing the appropriate suture for each type of tissue.

i. Demonstrate knowledge of suture materials and when each may be used.

ii. Demonstrate knowledge of needle types and when they are used.

iii. Evaluate each patient for healing factors when choosing suture or wound closure.

10. Utilize safety precautions while performing all perioperative roles.

a. Demonstrate universal and standard precautions.

i. Perform sharps handling using sharps safety concepts.

b. Apply latex awareness for allergy situations.

c. Demonstrate ergonomic movements.

d. Demonstrate awareness of fire safety precautions.

11. Demonstrate safe medication handling and preparation.

a. Label all medications on the field.

b. Enforce the six rights of medication safety.

c. Communicate all required information while handling and passing medications.

12. Demonstrate knowledge of surgical specialties by completing a surgical case count rotation according to the following requirements:

a. Scrub in and complete a minimum of 120 surgical cases using the following formula:

i. Complete 30 cases of general surgery.

1. 20 minimum in the first scrub role.

a. Demonstrate all duties of the perioperative first scrub role for each case.

2. 10 maximum counted toward the total in the second scrub role.

a. Demonstrate duties of a partial first scrub role or a second scrub role during the case.

ii. Complete 90 cases in other surgical specialties.

1. 60 cases in four minimum specialties in the first scrub role.

a. 10 minimum cases to qualify a completed specialty.

2. 30 cases maximum counted toward the total in the second scrub role.

3. Execute competency utilizing the following possible services:

a. Cardiothoracic

b. Genitourinary

c. Maxillo/facial and oral

d. Neurologic

e. Obstetric and gynecologic

f. Ophthalmologic

g. Orthopedic

h. Otorhinolaryngologic

i. Peripheral vascular

j. Plastics and reconstructive

k. Procurement and transplant

13. Demonstrate effective documentation and verification of each completed surgical procedure.

a. Document each surgical procedure according to specialty and role of participation.

b. Document each case according to AST (Association of Surgical Technologists) core curriculum.

c. Verify the role in which each case was performed.

d. Count only operative procedures toward the ‘first scrub’ role.

e. Verify that diagnostic procedures only qualify as a second scrub.

14. Document all observation role participation.

a. Observation of any case that does not fit any role criteria as defined above.

15. Demonstrate participation and completion of all required documentation.

a. Case counts

b. Case role verification

c. All clinical evaluation tools

d. Program authorization for completion

e. Timecards

16. Establish cohesive relationships with surgical team members.

a. Communicate effectively.

b. Request supplies and assistance when appropriate.

c. Demonstrate problem solving skills.

d. Show critical thinking while obtaining solutions to tasks.

e. Demonstrate employability qualities.

i. Prompt arrival time

ii. Preparedness for surgical cases

iii. Professional behaviors